NEW MEMBERSHIP FORM

First Name

Last Name

Street Address

City

Street Address Line 2

Region/State/Province

Postal / Zip code

Phone

Birthday

Occupation & Employer

Wedding Anniversary

Facebook Tag

Instagram Tag

Emergency Contact

First Name

Relationship

First Name

Relationship

Were you involved in auxiliaries at another church or ministry before coming to the church? If Yes, what was your involvement?

Last Name

Phone

Last Name

Phone

Please list what ministries you may be interested in. (Examples: Outreach, Performing Arts, First Impressions, etc.)

Child(ren) Information

Child #1 First Name

Child #1 Birthday

Child #2 First Name

Child #2 Birthday

Child #3 First Name

Child #3 Birthday

Child #1 Last Name

Child's #1 School/ Grade

Child #2 Last Name

Child's #2 School/ Grade

Child #3 Last Name

Child's #3 School/ Grade

Child #4 First Name

Child #4 Last Name

Child #4 Birthday

Child's #4 School/ Grade

Membership Commitment

* Weekly participation in Sunday Worship & Midweek Service

* I pledge of financial support for the church (Tithes & Offering)

* Willingness to support and build the church in other ways

Your Signature

Select a date

Thanks for submitting!

NEW MEMBERSHIP FORM

Emergency Contact

Child(ren) Information

Membership Commitment

Contact Informtion

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